Article

Studies have suggested that constraint-induced therapy combined with
trunk restraint (CIT-TR) improves arm movement and reduces trunk compensation.
Whether participants who receive CIT-TR can translate the benefits to real-life
circumstances awaits further investigation. OBJECTIVE:
The effects of distributed
CIT-TR (dCIT-TR) on motor function, daily function, quality of life (QOL), and
arm-trunk control were investigated. DESIGN: The study was a single-blind,
randomized controlled trial. SETTING: The study took place at 4 hospitals.
PARTICIPANTS: Participants were 57 people who had had a stroke 6 to 55 months
earlier. INTERVENTION: Participants received a dose-matched intervention (2 hours
per day, 5 days per week, for 3 weeks) of dCIT-TR, distributed constraint-induced
therapy (dCIT), or control therapy. MEASUREMENTS: The Action Research Arm Test
(ARAT), Motor Activity Log, Frenchay Activities Index (FAI), and Stroke Impact
Scale (SIS) were used to evaluate motor function, daily function, and QOL. Data
for reaching kinematics were recorded. RESULTS: Participants receiving dCIT-TR
and dCIT exhibited higher overall scores on the ARAT, FAI, and hand function
domain of the SIS and better quality of movement and larger amount of use (of the
affected arm) on the Motor Activity Log than participants in the control group.
Participants receiving dCIT-TR further demonstrated greater improvements on the
ARAT grip subscale and FAI outdoor activities scale than participants receiving
dCIT or participants in the control group. However, participants receiving dCIT
showed greater improvements on the strength domain of the SIS after training than
participants receiving dCIT-TR or participants in the control group. Limitations
Research with a larger sample size is needed. CONCLUSIONS: Participants who
received dCIT-TR were able to translate gains in arm-trunk control into
functional performance and QOL, specifically in grip function and outdoor
activities. A long-term study to examine the recovery course for force output may
be needed to evaluate people's perception of less improvement in strength after
dCIT-TR.

Langue : ANGLAIS